DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blaser, Mitchell Holt	DOIID	901080	NAIC NPN	17795562

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	1/4/2016		7/31/2026
Active	Resident	Agent	Property	1/4/2016		7/31/2026
Active	Resident	Surplus Lines Broker	Not Applicable	10/18/2019		7/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2026	07/31/2026
Surplus Lines Broker	05/15/2026	07/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AGCS Marine Insurance Company	300403	Agent - Casualty	7/22/2022	12/2/2025
Inactive	AGCS Marine Insurance Company	300403	Agent - Property	7/22/2022	12/2/2025
Active	Illinois Casualty Company	1250052	Agent - Casualty	6/3/2024
Active	Illinois Casualty Company	1250052	Agent - Property	6/3/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Risk Placement Services Inc	509419	Agent - Casualty	5/6/2024	5/8/2025
Inactive	Risk Placement Services Inc	509419	Agent - Property	5/6/2024	5/8/2025
Inactive	Risk Placement Services Inc	509419	Surplus Lines Broker - Not Applicable	5/6/2024	5/8/2025